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Evaluation of alignment in total knee arthroplasty: a prospective study
K S Manjunath1, K G Gopalakrishna, G Vineeth
1Department of Orthopaedics, Bangalore Medical College and Research Institute, Fort, K. R. Road, Bangalore, 560002, India, kmanjunath215@gmail.com.
Summary
Accurate alignment of knee implants during total knee replacement surgery is crucial for optimal patient outcomes. Precise alignment of the mechanical and tibiofemoral axes significantly improves both knee function and patient satisfaction.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Radiology
Background:
- Total knee arthroplasty (TKA) success depends on surgical precision, implant design, and patient rehabilitation.
- Implant positioning directly impacts knee stability, durability, and patellar tracking.
- Accurate alignment evaluation in TKA is essential for understanding functional outcomes.
Purpose of the Study:
- To assess the accuracy of limb and component alignment in jig-assisted TKA.
- To correlate functional outcomes with achieved alignment parameters in TKA patients.
Main Methods:
- Prospective study of 120 knees in 80 patients undergoing TKA.
- Preoperative and postoperative long-leg radiographs and CT scans were utilized.
- Knee Society Score was used for functional outcome evaluation over a 36-month follow-up.
Main Results:
- Postoperative mechanical axis alignment correlated with significantly better knee scores for 'inliers' versus 'outliers'.
- Tibiofemoral axis alignment showed extremely significant improvements in both knee and functional scores for 'inliers'.
- Femoral and tibial component alignments (sagittal, coronal, rotational) consistently fell within the 'inlier' range for all cases.
Conclusions:
- Achieving mechanical axis and tibiofemoral angle alignment within ±3° is critical.
- Precise prosthetic placement within ±3° in all three planes leads to excellent functional outcomes in TKA.
- Accurate alignment is a significant predictor of successful TKA results.
